title: [Primary hepatic lymphoma: an infrequent cause of focal hepatic lesion].
abstract: Primary hepatic lymphoma (PHL) is confined to the liver with no evidence of extrahepatic lymphomatosis. Histopathologically, the PHL belongs to the group of non-Hodgkin's lymphomas and the most common subtype is the diffise large B-cell lymphoma. We present a 72-year-old woman, with no relevant antecedents and the following symptoms: early satiety, abdominal discomfort and rapid weight loss. Liver function tests are normal, erythrocyte sedimentation rate is accelerated and LDH progressively increases during the hospitalization. Imaging studies (ultrasound, CT scan, nuclear magnetic resonance) show a multilobued mass of around 12 cm of diameter in the right hepatic lobe. Tumoral and virological markers are negative. The pathology of an echo-guided biopsy informs a massive infiltration by a diffuse large B-cell lymphoma. The immunohistochemical study shows CD20+, CD45+ and negative CD3, CKAE1, AE3, Hepatocyte and HMB45. The citology of pleural liquid is negative for atypia, peripheral blood smear shows no signs of leukemia, bone marrow biopsy is negative for lymphomatous infiltration, and gallium scintigraphy and body CT scan do not reveal extrahepatic lesions. The patient starts chemotherapy with cyclophosphamide and methylprednisolone but worsens and dies two weeks after beginning treatment. We conclude that our patient had a rare disease with an unresectable lesion, poor prognostic factors and high recurrence risk. Chemotherapy is the treatment of choice in these cases.
authors.affiliation: Servicio de Gastroenterología, Hospital Gral San Martin de La Plata, Provincia de Buenos Aires, Argentina. carobalduzzi82@hotmail.com
authors.forename: Carolina
authors.initials: C
authors.lastname: Balduzzi
authors.forename: Martin
authors.initials: M
authors.lastname: Yantorno
authors.forename: Iván
authors.initials: I
authors.lastname: Mosca
authors.forename: Mirta
authors.initials: M
authors.lastname: Apraiz
authors.forename: María J
authors.initials: MJ
authors.lastname: Velázquez
authors.forename: María del Carmen
authors.initials: Mdel C
authors.lastname: Puente
authors.forename: Valeria
authors.initials: V
authors.lastname: Moragrega
authors.forename: Regina
authors.initials: R
authors.lastname: Ligorría
authors.forename: Anabel
authors.initials: A
authors.lastname: Ottino
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Belloni
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Barbero
authors.forename: Alejandro
authors.initials: A
authors.lastname: Jmelniztky
authors.forename: Néstor
authors.initials: N
authors.lastname: Chopita
mesh_terms: D000368:Aged; D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood; D003520:Cyclophosphamide / Q000627:therapeutic use; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000188:drug therapy; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000188:drug therapy; D011241:Prednisone / Q000627:therapeutic use
chemical_list: D018906:Antineoplastic Agents, Alkylating; D014408:Biomarkers, Tumor; D003520:Cyclophosphamide; D011241:Prednisone